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Effect of the Quran sound on labor pain and other

maternal and neonatal factors in nulliparous women

Roghayeh Bayrami1, Hossein Ebrahimipour2

Journal of Research & Health Abstract

Social Development & Health Promotion
Research Center Because non-pharmacological methods of pain relief have no side
effects on the mother and fetus and are easy to use, they are applicable
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Vol. 4, No.4, Winter 2014

Pages: 898-902
Original Article in the labor process of labor. The present study was conducted to
determine the effect of Quran sound on the intensity of pain and
1. Correspondence to:  MSc in
Midwifery, Instructor Nursing and
other parameters influencing the first stage of labor, as well as the
Midwifery School, Urmia University of nulliparous women, admitted to Ghamar-Bani Hashem Hospital
Medical Sciences, Urmia, Iran in Khoi city, Iran. This was a quasi-experimental study conducted

Tel/Fax: +98 51 34182572 on 60 nulliparous women, selected and randomly divided into two
Email: bayramir891@mums.ac.ir
groups. Immediately after entry to the delivery room, vital signs
2. Assistant Professor, Health Sciences
Research Center, Department of Health
and Management, School of Health,
Mashhad University of Medical Sciences,
Mashhad, Iran
were recorded and the intensity of baseline pain was monitored and

recorded using Visual Analog Scale. Then, only for the trial group,
during the active phase of first stage of delivery, Quran sound (recited

by Abdolbaset) was played alternately through headphones for half
Received: 4 Dec 2012 an hour; then, the intensity of pain and vital signs were measured

Accepted: 28 Sep 2013
and recorded. The statistical t-test was used for analysis of data, and
How to cite this article: Bayrami R, the significance level was considered less than 0.05. The majority
Ebrahimipour H. Effect of the Quran sound
of subjects were 20-24 years old. The intensity of pain during the
on labor pain and other maternal and neonatal
factors in nulliparous women. J Research
Health2014; 4(4): 898-902.

v e
active phase of delivery showed a significant differences in the two
control and trial groups. It is recommended that the Quran sound be

used as a non-pharmacological method for pain relief, shortening
the duration of the first stage delivery, improving the vital signs, and

increasing the infant’s Apgar score.

r c Keywords: Quran Sound, Delivery, Pain

In women’s lives, labor is one of the most
important crises, in which devastating effects
of mental, emotional, and physical stresses are
labor pain confuses the mother, disrupts her
mental health, and affects her relationship
with her child and spouse. Such a pain can
lead to distress, fear and anxiety about the
inevitable. Labor is an event with deep mental, next pregnancy [3].
social, and emotional dimensions, remaining in Pain elimination is considered as one of
the mother’s mind for ever and any unpleasant the primary priorities in satisfying human
event can lead to terrible psychological impacts physiological needs [4]. Hence, labor pain
[1]. Pain is a mental experience, influenced by relief has long been an important issue in
various physiological, mental, environmental, midwifery. Additionally, as the elective
and cultural factors [2]. Labor pain is one of cesareans rates have recently been increased,
the most severe pains that women experience in health officials have focused on promotion
their life time, affecting all aspects of a pregnant of painless as well as less-painful methods
mother as well as her family’s lives. Intense for natural childbirth. These methods aim
Bayrami et al.

to promote the maternal health level besides guide [13, 14], sample size comprised of
reducing cesarean and mother mortality rates 60 women that were randomly divided into
due to complications of anesthesia, bleeding trial (30 women) and control (30 women)
and infection; also propagate natural childbirth groups. Study inclusion criteria were: being
and encourage mothers to choose it. primiparous, being in the active labor phase
A non-pharmacological method of pain relief is (dilatation of 4 cm), no history of childbirth or
music therapy, which increases both stimulation surgery, and no history of addiction, chronic
and pain thresholds. Music is the most ordinary pains, or disorder of 5 senses. This study was
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and primary tool for relieving the pain and approved by the ethics committee of Urmia
diverting the mind [5]. Music has many physical University of Medical Sciences. Prior to
and mental therapeutic properties [6]. Listening performing the practical stages, objectives
to one’s favorite music reduces the pain signal and methods of the study were explained
transmission to the central nervous system, to the participants and their written consent
leading to relaxation of muscles, diverting the was obtained. Also, participants were assured
mind from pain, and less pain intensity [7].
Music reduces patient’s need for medication,
and leads to reduced heart rate and deepening D
of confidentiality of data. Data collection

tools and methods were regular observations
and questionnaire. The Beck’s Depression
of breathing; it also has positive effects on
pain, anxiety, and depression [8]. Many studies
have been conducted to evaluate the effects of
music. Larson-Beck in his study revealed that
f S
Inventory was initially used to detect any
depressive disorder in the participants. A
questionnaire was also applied in two parts;
the first part included personal details and
music has pain-reducing effects [9]. Ajorpaz,
in a clinical trial conducted on 50 mothers
undergoing cesarean in 2010, concluded that
the level of anxiety was reduced in the trial
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questions about music and Quran which was
completed before transferring to the labor
room. The second part contained questions
for pain assessment on a numerical scale of 0

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group after hearing the Quran sound through
headphones [10]. In a double-blind clinical
trial, Keshavarz showed that after playing the
to 10, which was completed during the labor.
In the labor room, when the patient expressed
her pain for the first time, it was evaluated and

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Quran sound, the trial group had lower level of
pulse and breathing as well as higher oxygen
saturation rate compared with the control group
recorded by the numerical scale tool. In the
trial group in the first stage of delivery, the
Alrahman verse recited by Abdolbaset was

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[11]. Considering that today, physiologically-
normal and healthy pregnancy, delivery with
minimum intervention along with physical,
mental, and social maternal care, as well as
played twice; first time during 4-6 dilatation
and second time during 7-10 dilatation, each
time for 30 minutes, using a Walkman and
headphone. The patient was requested to close
reduction of cesarean rate to around 10-15%, her eyes while listening to reduce any visual
are among the objectives of Islamic Republic of interference. The researcher was present in
Iran Ministry of Health [12] and international the room to minimize the environmental
organizations, this study was conducted to interfering factors. Immediately after listening
determine the impact of Quran sound on labor to Quran, the patient’s blood pressure, pulse
pain and other maternal and neonatal factors. rate, and breathing were measured again,
and the pain level was monitored every 30
Method minutes for 2 hours. All the above actions
This was a quasi-experimental study, conducted were also performed for the control group,
over a 6 months period at Ghamar-Bani-Hashem except playing the Quran sound. For validity
hospital in Khoy city, Iran. Study population of the questionnaire, it was consulted with
consisted of all nulliparous women admitted ten professors of the Urmia University of
for childbirth to this hospital. Given the study Medical Sciences, and for the reliability,
Effect of the Quran sound on labor in nulliparous women

test-retest method was used. For data collection, Independent t- test was used for analysis of the
mercury barometer and sweeping second hand relationships and differences.
watch were used in all research units. In this study,
the researcher and the trained colleagues visited Results
10 mothers that qualified as study subjects and Majority of subjects were 20-24 years old; 90%
recorded their pain intensities independently. The were housewives and 85% were happy with the
recorded results were almost similar. household income. Most participants (63.3%)
To obtain the results, the questionnaires were had high school education; 96.7% lived in
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first numbered, and then the collected data from urban and 3.3% in rural areas. There were no
each group were analyzed using SPSS software, differences between demographic indicators of
version 11.5. Descriptive statistics were used for trial and control groups. The obtained results are
tabulations, absolute frequency distributions and presented in five Tables.
percentage, and mean and standard deviation.

stage of labor

Group Case, Mean ±SD Control. Mean ± SD

Table 1 Mean and standard deviation distribution and comparison of pain intensity between the two groups in the first

Statistical test
df T
At entry
6 cm Dilatation
7 cm Dilatation

f S 0.4
Full dilatation


Case, Mean ±SD

e o9.4±0.18 0.001

Table 2 Mean and standard deviation and comparison of the first stage duration between the two groups
Control, Mean ±SD

Statistical test

P df T
Duration of the first stage 3.3±0.66 4.2±0.55 0.001 58 -5.5

the two groups

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Table 3 Mean and standard deviation distribution of systolic blood pressure of subjects in the first stage of delivery in


At entry
During the first stage

A r Systolic blood pressure

Case, Mean ± SD
Control, Mean ± SD
Statistical test

Table 4 Mean and standard deviation distribution of diastolic blood pressure of subjects in the first and second stages
of the diastolic pressure control in the two groups
Group Diastolic blood pressure Statistical test
Case, Mean ± SD Control, Mean ± SD P df T
At entry 108.83±7.39 110.1±3.03 0.21 58 -1.2
During the first stage 102.4±7.61 121.1±6.82 0.001 58 -9.9

Table 5 Distribution of mean and standard deviation and comparison of the infant’s Apgar score of the first minute
between the two groups
Statistical test
Case, Mean ±SD Control, Mean ±SD
Infant’s Apgar score P df T
of the first minute
8.7±0.43 8.4±0.62 0.03 58 2.1

Bayrami et al.

Discussion of education could endure more pain [21]; in

Results of the study revealed that listening to this study, the infants’ Apgar scores in trial and
the Quran sound had an impact on the intensity control groups were significantly different. In a
of pain in the first stage of labor in nulliparous study by Ansari, Quran sound was considered
mothers. Fan, in his study also stated that as the conventional music of Islamic societies
non-invasive pain reduction methods such as [22]. Therefore, Quran sound can be regarded
music therapy may be effective on labor pain as a type of music. Chelen believes, music can
relief, especially in the first and third stages bring peace and comfort; thus, reduce pulse
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in nulliparous women [15]. In another study, rate, blood pressure, and respiratory rate, due
Abhari showed that music has pain-reducing to the reduced adrenalin level [23]. Music has
effects on the first stage of labor in nulliparous an impact not only on adults and children, but
mothers [16]. In the present study, listening to even on the fetus. The initiative used in this
the Quran sound resulted in a shorter duration of respect involved fetus reaction to melodic
first stage of labor in the trial group (P < 0.001). sounds, including singing of the mother. During
In a study by Dahcheshmeh, it was also shown
that listening to music during labor caused
reduction in the first stage of labor duration D
filming this procedure, specific reactions were

observed on the fetus face, considered as signs
of response to the melodic sounds [10]. Simons
[17]. In a study by Mosavi titled “comparative
assessment on the effects of Quran sound and
music on the intensity of pain in the active
phase of the first stage of labor in nulliparous
f S
in his study titled “effect of music on the labor
pain” concluded that music was very desirable
for women undergoing labor and most of them
were tended to repeat the same experience in
women”, it was revealed that compared to the
control group, both Quran sound and music can
reduce the labor pain at least in the first 4 hours
of the active phase. However, the intensity of
e o
their future labors [24].
Study limitations:
Since it was not possible to conduct a blind
study, the interviewer’s views may have

than the music group; duration of the active
phase in the intervention groups was shorterv
pain in the Quran group was significantly less influenced the results in the first stage of data

compared with the control group, and in the

Quran group it was significantly shorter than the
music group [18]. According to the findings of
Given the obtained results, Quran sound can
be used in the first stage of labor as a non-

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this study, the mean values of vital signs (pulse
rate, respiratory rate, and diastolic and systolic
blood pressures) in trial and control groups
showed statistically significant differences.
pharmacological pain management and for
shortening the first stage of labor, as well as
improving other parameters including vital
signs and fetal outcomes.
These results are similar to the results of a
study assessing the effects of Quran sound on Acknowledgements
the vital signs of patients before open heart and The present study was the result of a research
after gastric surgeries [19]. In the present study, project approved by Urmia University of
there were no significant differences between Medical Sciences. We thank all officials and
age, occupation, income, residence area, and those involved in practical and scientific
level of education and the labor pain in the two affairs that assisted us in this study. We also
groups. Peng in his study on common behaviors thank all mothers for their cooperation.
during labor concluded that there were no
significant differences between occupation, Contributions
education, age, and number of pregnancies Study design: RB
and labor pain [20]. Yet, Merchetz in his Data collection and analysis: RB
study showed that women with higher levels Manuscript preparation: RB, HEP
Effect of the Quran sound on labor in nulliparous women

Conflict of interest patient's vital signs before Open Heart surgery.

"The authors declare that they have no Asrar2002;10(2):52-58. [in Persian]
competing interests." 15. Fanne G, progression of labor pain in primiparas
and multiparas. Nursing research 1998; 47 (2):214-
Refrences 225.
1. Omidvar A, Jafar nejad F. The evaluation and comparison 16. Rezaie Abhari F, Parhizkar S, Yaghoobi T.
of quality of psycho-physical care during labor in the view Investigation on the effect of music on the intensity of
of prim gravid and multiparus women. Journal Mashhad labour pain. Armaghan Danesh2000; 5 (17, 18):36-44.
Downloaded from jrh.gmu.ac.ir at 15:28 IRDT on Sunday May 3rd 2015

School Nurs Midw2002;5(15-16): 73-78. [in Persian]

2. Leeman L, Fontaine P, King V, Klein MC, Ratcliffe 17. Safdari dehcheshme F, Salehian T, Kazemian A,
S. The nature and management of labor pain: part I. Froozandeh N, Safarzadeh A, Hasanpoor dehkordi A.
Nonpharmacologic pain relief. Am Fam Physician2003; The effect of music on labor pain in the active phase
68(3): 1109-12. of the first stage of labor in primiparous women. J
3. Wall D, Melzack R. Text book of pain. 3th ed. Shahrekord Univ Med Sci2007; 10 (4):65-71. [in
philadelphia, Mc Graw H.CO; 1999.11.
4. Dugass B. Principles of Patient Care, A comprehensive
review of nursing. Translate in Atash zadeh F and et al.

18. Moosavi A, Mir moolai T, Ashayeri H. A
comparative study the Effect of Holy Quran and
Tehran, Golban poplication 2002: 528-530.
5. Ilkhani M. Evaluation of effect of relaxation methods
on patients with cancer in cancer wards in selected
educational hospitals in Tehran [Dissertitation]. shahid
f S
music on intensity of pain during the active phase of
labor in nulliparous women admitted to two selected
hospitals in Tehran [Dissertitation] Tehran medical
science university.
beheshti medical science university. 1990: 178-220.
6. Colwell Cynthia. Music as distraction and relaxation
to reduce chronic pain and narcotic ingestion case. Music
Therapy Perspective1997; (15): 24-30
e o
19. Nikbakht nasrabadi A. Investigation the
effectiveness of Holy Quran reciting song on reduction
of pain. Daneshvar1996; (13): 31-36. [in Persian]
20. Pong et al. Stress and delivery. Annals of medicine.

Amer J Nurs(AJN)1998; 98 (4): 27-32

7. Bral E. Caring for adults with chronic cancer pain.

8. Myskja A, Lindbak M .Examples of music in clinical
1999, 40 (23):394.
21. merkatz I,complication of pregnancy: medical,su
rgical,gynaecologic,psychosocial and perinatal. New

c h
medicine.Tidsskr Nor Laegeforen 2000; 120(10): 1186-90
9. Beck L. The therapeutic use of music for cancer
York: Williams and Wilkins 1998.
22. Ansari Jaberi A, Negahban Bonabi T, Sayadi
Anari AR, Agha Mohamad Hasani P. The effect of the

related pain. Oncol Nurs Forum1991; 18 (8): 1334-5.
10. Mir bagher ajorpaz N, Ranjbar N. The effect of holy Koran Reciting on the depressed patients in psychiatry
Quran on anxiety of patients before cesarean section. J department of Moradi Hospital in Rafsanjan. Sci

Qom Univer Med Scien2009;4(1):15-19. [In Persian]
11. Keshavars M, Eskandari N, Jahdi F, Ashaieri H,
Hoseini F, Kalani M. The effect of holly Quran recitation
on physiological responses of premature infant.
Koomesh2009; 11 (3). [In Persian]
J Kurdistan Univ Med Sc2005; 36 (10): 48-42. [in
23. Chlan L, Tracy MF. Music Therapy in Critical
Care: Indications and Guidelines for Intervention. Crit
Care Nurse1999; 19 (3): 35-41
12. Fahami, S Masoudfar S, Davazdahemami SH. Effect 24. Sammons LN. The use of music by women during
of Lamaze practice on the outcome of pregnancy and childbirth. J Nurse Midwifery1984; 29(4): 266-70.
labor in primipara women referred to selected university
hospitals in 2005. Iranian J Nursing Midwifery Res2006;
11(4): 19-26.
13. McCaffrey R, Freeman E. Effect of music on chronic
osteoarthritis pain in older people. J Adv Nurs2003; 44
14. Ildarabadi E, Salehmoghaddam A R, Mazloom
S R. The effect of holy Quran recitation on the